The Association between Household Socioeconomic Position and Prevalent Tuberculosis in Zambia: A Case-Control Study

Delia Boccia, James Hargreaves, Bianca Lucia De Stavola, Katherine Fielding, Ab Schaap, Peter Godfrey-Faussett and Helen Ayles

PLOS ONE, 2011, vol. 6, issue 6, 1-11

Abstract: Background: Although historically tuberculosis (TB) has been associated with poverty, few analytical studies from developing countries have tried to: 1. assess the relative impact of poverty on TB after the emergence of HIV; 2. explore the causal mechanism underlying this association; and 3. estimate how many cases of TB could be prevented by improving household socioeconomic position (SEP). Methods and Findings: We undertook a case-control study nested within a population-based TB and HIV prevalence survey conducted in 2005–2006 in two Zambian communities. Cases were defined as persons (15+ years of age) culture positive for M. tuberculosis. Controls were randomly drawn from the TB-free participants enrolled in the prevalence survey. We developed a composite index of household SEP combining variables accounting for four different domains of household SEP. The analysis of the mediation pathway between household SEP and TB was driven by a pre-defined conceptual framework. Adjusted Population Attributable Fractions (aPAF) were estimated. Conclusions: While the fight against HIV remains central for TB control, interventions addressing low household SEP and, especially food availability, may contribute to strengthen our control efforts.

Date: 2011
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0020824

DOI: 10.1371/journal.pone.0020824

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